Between 9-11 December 2014, WHO convened a meeting of public finance and health financing policy experts and practitioners to discuss a number of topics related to increasing the level, and maximising the use of public funding for health services in support of UHC. A key message from the World Health Report 2010 was the central importance of public funding for health services in order to both improve and maintain coverage, and progress towards UHC. Furthermore, general budget revenues must play the leading role, given the relatively small size of the formal sector in most low and middle income countries.
This meeting brought together experts from ministries of health (Benin, Burundi, Ghana, Laos, United Republic of Tanzania) and ministries of finance (Netherlands, Philippines, South Africa), as well as health financing and public finance management experts from a range of international organisations, including the World Bank, OECD, DfID, USAID, DFAT, the Global Fund, the Bill & Melinda Gates Foundation, PEPFAR, UNAIDS, and CABRI, as well as academia, civil society and other technical specialists in the field. Colleagues from a number of disease focused programmes at WHO also attended.
A collaborative agenda for future work
Extensive presentations and discussions were held on a range of topics, including how Ministries of Finance view the health sector, what they need from the health sector and what the health sector needs from Ministries of Finance; fiscal space and sustainability issues in the health sector; future financing of global health initiatives / programmes; revenue and expenditure projections, benchmarks and targets; aligning public finance management rules with desired health service delivery and payment reforms; existing networks bringing together health and finance officials and evidence collection on good and bad budgeting practices
Participants then conducted group-work focusing on the development of a concrete agenda around four topic areas:
- Aligning public finance management and health financing policy at the country level e.g. identifying / developing diagnostic tools to identify budgeting bottlenecks which hinder progress on health service payment reforms
- Benchmarking and targets, fiscal space, and health spending projectionse.g. develop a platform to exchange ongoing projection work, and provide guidance on their appropriate use.
- Integration of global health initiatives with domestic health service delivery and health financing systems e.g. review of the fiscal / health financing situation in selected countries graduating from support from global health initiatives and establishment of a process to discuss issues arising
- Development of regional networks bringing together health and finance/budget officials to improve dialogue and understanding e.g. build on existing / develop new networks to bring together health and finance/budget officials to foster dialogue and understanding, and conduct joint diagnostic work
These formed the basis for an agreed collaborative agenda for future work with a view to strengthening health systems and supporting efforts to progress towards universal health coverage. Detailed products are being defined, together with timelines and responsibilities across agencies. The final agenda will be made available for distribution.